Well, the media has occasional frenzies over the rising tide of male ‘boob jobs’, but to the average paediatrician it’s the rare adolescent that can’t take his T-shirt off because of pubertal breast enlargement that causes real concern. How should such a potentially disabling and yet ultimately short-lived problem be addressed?

more…

Have you (yet) had a parent ask for a referral for tongue tie division to assist with a poorly feeding baby? What is the right answer to this question; more…

A 5 year old boy was admitted to a rural New Zealand hospital with 10 day history of abdominal pain. The pain was localised to the RIF with guarding and examination revealed a palpable mass in the RIF. He had previously presented with a 1 day history of severe abdominal pain and fever and had been discharged the following day with a diagnosis of gastroenteritis. He was transferred to the tertiary hospital and a diagnosis was made on ultrasound scan of appendiceal mass with abscess. His condition was stable. He was commenced on conservative management and supportive care with intravenous (iv) antibiotics followed by a 2 week course of oral antibiotics. He responded well to conservative management and was scheduled for appendectomy after an interval of 6-8 weeks. You wonder whether it is necessary, now he is well, for him to have an appendectomy.

more…